News & Research

Sangita Sharma, PhD is currently conducting research at the University of Hawaii in Honolulu, Hawaii. She is the recipient of an ADA Clinical Research Award for her project entitled, “Intervention for a chronic disease epidemic: community

health initiatives and promotion strategies for diabetes prevention (ICE CHIPS) in Native North Americans”.

American Indians, Alaskan Natives and other native populations in North America are showing signs as a group of succumbing to the diabetes epidemic that affects millions of Americans. Dr. Sharma’s research focuses on diabetes prevention and education in the Native North American (NNA) community. Diabetes research has many focus areas, but Dr. Sharma believes that it should incorporate culturally diverse approaches to prevention as well. She states, “We need to understand the causes of diabetes and the underlying mechanisms, but we also need to research the best approaches for prevention of diabetes in different populations.”  Dr. Sharma’s approach to prevention of diabetes in this ethnic population is a comprehensive program named Healthy Foods North. In this program, in-depth community involvement focuses on an individual’s dietary intake and physical activity level.

The Healthy Foods North program embraces the American Diabetes Association’s position on the prevention of the risks for diabetes. According to the ADA’s “Standards of Medical Care in Diabetes” published in Diabetes Care (Diabetes Care 2008 31: S61--S78), individuals at high risk for developing type 2 diabetes should participate in structured programs that emphasize lifestyle changes that include moderate weight loss (7% body weight) and regular physical activity (150 min/week), with dietary strategies including reduced calories and reduced intake of dietary fat. These lifestyle changes can reduce the risk for developing diabetes.

According to Dr. Sharma’s preliminary research, the NNA population exhibits a sedentary lifestyle, a strong risk factor for development of type 2 diabetes. Preliminary data has already confirmed that this population’s dietary consumption of fewer fruits and vegetables, as well as more high fat, high sugar and processed foods, contributes to the increased incidence of type 2 diabetes in this population. So, in an attempt to prevent type 2 diabetes in the NNA population, she has chosen to apply a lifestyle modification program to participating individuals in her research study.

Quantitative information on research participant’s height, weight, amount of physical activity, and diet is collected for comparison pre- and post-intervention. Psychosocial factors that affect health behaviors and food choices are also collected as part of the overall assessment. Administering two newly created quantitative food frequency questionnaires for use by the communities will help determine food and nutrient intake. In addition to the dietary intervention, the research study is incorporating a physical activity component as well. Any community member can collect (from the stores in town or project staff), a pedometer which measures their activity levels. Friendly competition is also used as a motivator, with community walk teams formed to see who walks the most steps.

Involving the entire community is the unique factor in Dr. Sharma’s ADA- funded research program. She is engaging the community food stores to collaborate with the program by getting them to stock more healthy foods, providing Healthy Foods North educational materials for them to display as well as performing taste tests and recipe ideas for the customers. Not only is Dr. Sharma’s program going to reinforce community programs aimed at physical activity but she will maintain the longevity of the program by having it integrated into community programs by the local government.  The Healthy Foods North program will be advertised and promoted through local community events, health centers and radio and other media. The program researchers have also conducted workshops within the communities to determine the most acceptable, healthier food alternatives.

Dr. Sharma states, “My ADA funding means that I can undertake and subsequently evaluate the program to determine if it really works to improve diet and physical activity and reduces risk of diabetes. If the program is as successful as I am confident it will be, then I hope to be able to utilize the approach in other high-risk diabetes populations”.